Posts filed under ‘Infecciones virales’

Follow-up brain imaging of 37 children with congenital Zika syndrome: Case series study

BMJ 2017 Oct 13; 359:j4188

Calheiros de Lima Petribu N et al.

Abstract

Objective

To compare initial brain computed tomography (CT) scans with follow-up CT scans at one year in children with congenital Zika syndrome, focusing on cerebral calcifications.

Design

Case series study.

Setting

Barão de Lucena Hospital, Pernambuco state, Brazil.

Participants

37 children with probable or confirmed congenital Zika syndrome during the microcephaly outbreak in 2015 who underwent brain CT shortly after birth and at one year follow-up.

Main outcome measure

Differences in cerebral calcification patterns between initial and follow-up scans.

Results

37 children were evaluated. All presented cerebral calcifications on the initial scan, predominantly at cortical-white matter junction. At follow-up the calcifications had diminished in number, size, or density, or a combination in 34 of the children (92%, 95% confidence interval 79% to 97%), were no longer visible in one child, and remained unchanged in two children. No child showed an increase in calcifications. The calcifications at the cortical-white matter junction which were no longer visible at follow-up occurred predominately in the parietal and occipital lobes. These imaging changes were not associated with any clear clinical improvements.

Conclusion

The detection of cerebral calcifications should not be considered a major criterion for late diagnosis of congenital Zika syndrome, nor should the absence of calcifications be used to exclude the diagnosis.

FULL TEXT

http://www.bmj.com/content/359/bmj.j4188

PDF

http://www.bmj.com/content/bmj/359/bmj.j4188.full.pdf

 

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November 16, 2017 at 8:12 am

Eliminating viral hepatitis: time to match visions with action

Lancet  November 11, 2017  V.390 N.10.108 P.2121

EDITORIAL

Eliminating viral hepatitis: time to match visions with action

 

PDF

http://thelancet.com/pdfs/journals/lancet/PIIS0140-6736(17)32856-8.pdf

 

 

November 10, 2017 at 4:02 pm

HIV Drug Resistance — An Emerging Threat to Epidemic Control

N Engl J of Med October 2017 V.377 P.1605-1607

Perspective

Chris Beyrer, M.D., M.P.H., and Anton Pozniak, M.D.

There are now an estimated 19.5 million people worldwide living with HIV and receiving antiretroviral therapy (ART). That’s approximately half of all people thought to be living with the virus in 2017 — an extraordinary achievement in global health and human solidarity. The United Nations agencies, led by the Joint United Nations Program on HIV/AIDS (UNAIDS) and the World Health Organization (WHO), have committed to the goals of ending the AIDS pandemic as a public health threat by 2030 and ensuring that by 2020, 90% of people with HIV infection know they have it, 90% of those infected are receiving ART, and sustained viral suppression is achieved in 90% of those receiving treatment.1 This last goal is critically important both to individual health and survival and to epidemic control of HIV, since data continue to mount showing that viral suppression greatly reduces the risk of continued transmission — whether sexual or perinatal — of the virus…..

FULL TEXT

http://www.nejm.org/doi/full/10.1056/NEJMp1710608?query=infectious-disease

PDF

http://www.nejm.org/doi/pdf/10.1056/NEJMp1710608

November 7, 2017 at 7:17 am

An update on Zika virus infection.  

Lancet  November 4, 2017 V.390 N.10.107 P.2099-2109

REVIEW 

Prof David Baud, MD, Prof Duane J Gubler, ScD, Bruno Schaub, MD, Marion C Lanteri, PhD, Didier Musso, MD

Summary

The epidemic history of Zika virus began in 2007, with its emergence in Yap Island in the western Pacific, followed in 2013–14 by a larger epidemic in French Polynesia, south Pacific, where the first severe complications and non-vector-borne transmission of the virus were reported.

Zika virus emerged in Brazil in 2015 and was declared a national public health emergency after local researchers and physicians reported an increase in microcephaly cases.

In 2016, WHO declared the recent cluster of microcephaly cases and other neurological disorders reported in Brazil a global public health emergency. Similar clusters of microcephaly cases were also observed retrospectively in French Polynesia in 2014.

In 2015–16, Zika virus continued its spread to cause outbreaks in the Americas and the Pacific, and the first outbreaks were reported in continental USA, Africa, and southeast Asia.

Non-vector-borne transmission was confirmed and Zika virus was established as a cause of severe neurological complications in fetuses, neonates, and adults. This Review focuses on important updates and gaps in the knowledge of Zika virus as of early 2017.

PDF

http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(17)31450-2.pdf

November 3, 2017 at 8:20 am

HIV Drug Resistance — An Emerging Threat to Epidemic Control

N Engl J of Med Oct 2017 V.377 P.1605-1607

Perspective

Chris Beyrer, M.D., M.P.H., and Anton Pozniak, M.D

There are now an estimated 19.5 million people worldwide living with HIV and receiving antiretroviral therapy (ART). That’s approximately half of all people thought to be living with the virus in 2017 — an extraordinary achievement in global health and human solidarity. The United Nations agencies, led by the Joint United Nations Program on HIV/AIDS (UNAIDS) and the World Health Organization (WHO), have committed to the goals of ending the AIDS pandemic as a public health threat by 2030 and ensuring that by 2020, 90% of people with HIV infection know they have it, 90% of those infected are receiving ART, and sustained viral suppression is achieved in 90% of those receiving treatment.1 This last goal is critically important both to individual health and survival and to epidemic control of HIV, since data continue to mount showing that viral suppression greatly reduces the risk of continued transmission — whether sexual or perinatal — of the virus…..

PDF

http://www.nejm.org/doi/pdf/10.1056/NEJMp1710608

October 26, 2017 at 7:53 am

A Rose by Any Other Name: Practical Updates on Microbial Nomenclature for Clinical Microbiology

Journal of Clinical Microbiology January 2017 V.55 N.1 P.3-4

EDITORIAL

Colleen S. Kraft, Alexander J. McAdam, and Karen C. Carroll

aDepartment of Pathology and Laboratory Medicine, Division of Infectious Disease, Emory University, Atlanta, Georgia, USA

bDepartment of Laboratory Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, USA

cDivision of Medical Microbiology, Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

The clinical microbiology laboratory stands at the interface between basic science, including the study of phylogeny, and applications of science in the very practical world of medical care.

In this context, it is important that laboratory reports balance scientific accuracy with medical utility, and it is particularly difficult to do this in the naming of microorganisms.

New organisms are discovered and named, and our understanding of the relationships between known organisms improves, resulting in the reclassification and renaming of organisms as they are sorted into the correct groups.

In this issue of Journal of Clinical Microbiology, we are pleased to provide several minireviews that are intended to help clinical microbiologists keep up-to-date with changes in nomenclature for bacteria (1), parasites (2), viruses (3), and fungi (4).

Most of these minireviews focus on human pathogens, but the minireview on viruses includes those affecting nonhuman animals. An article about mycobacterial nomenclature is in preparation and will be published in Journal of Clinical Microbiology when available.

The idea for this informative resource was proposed by Dr. Karen Carroll at the editors’ meeting in 2015.

The editors enthusiastically agreed these reviews would be a useful resource for clinical microbiologists, infectious diseases physicians, laboratory technologists, pharmacists, and infection preventionists, in addition to fostering discussion and teaching of trainees and students.

Several editors volunteered to write the articles, and we plan to update these minireviews every 2 years if they prove to be as useful as we expect….

PDF

http://jcm.asm.org/content/55/1/3.full.pdf+html

October 19, 2017 at 3:02 pm

Pregnant Women Hospitalized with Chikungunya Virus Infection, Colombia, 2015

Emerging Infectious Diseases November 2017 V.23 N.11

Maria Escobar, Albaro J. Nieto, Sara Loaiza-Osorio, Juan S. Barona, and Fernando Rosso

Fundación Clínica Valle del Lili, Cali, Colombia (M. Escobar, A.J. Nieto, S. Loaiza-Osorio, F. Rosso); Icesi University, Cali (M. Escobar, A.J. Nieto, J.S. Barona, F. Rosso)

In 2015 in Colombia, 60 pregnant women were hospitalized with chikungunya virus infections confirmed by reverse transcription PCR.

Nine of these women required admission to the intensive care unit because of sepsis with hypoperfusion and organ dysfunction; these women met the criteria for severe acute maternal morbidity. No deaths occurred.

Fifteen women delivered during acute infection; some received tocolytics to delay delivery until after the febrile episode and prevent possible vertical transmission. As recommended by a pediatric neonatologist, 12 neonates were hospitalized to rule out vertical transmission; no clinical findings suggestive of neonatal chikungunya virus infection were observed.

With 36 women (60%), follow-up was performed 1 year after acute viremia; 13 patients had arthralgia in >2 joints (a relapse of infection).

Despite disease severity, pregnant women with chikungunya should be treated in high-complexity obstetric units to rule out adverse outcomes. These women should also be followed up to treat potential relapses.

PDF

https://wwwnc.cdc.gov/eid/article/23/11/pdfs/17-0480.pdf

October 18, 2017 at 8:27 am

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